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)

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.

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

解體主義 建築 디자인의 表現特性에 관한 硏究

尹道根,李正旭,李一珩,黃泰周 弘益大學校 1993 弘大論叢 Vol.25 No.2

The characteristic of Formal Expressions in Deconstructive Architecture were summerized in four features through the results of the analysis. They are as follows. 1) `The relation of architectural element and intertextuality' is expressed in discontinuation of context and refusal of functional building. 2) The concept of trace expresses as connection of place, decomposing of excavation of trace, trace of axis, trace of fragments. 3) Anti-gravity expression is there to express of open cubic, to outgrow of rectangular system, to outgrow of volume, to separate of ground connection. 4) The complex compositon of abstracted geometric form is there to abstracted geometry about indefinite shape, to layer through the overlap and collage, to de-meaning and amusement of form through the pursuit of uncertainty, to indeterminate of formal meaning through operation and composion of similar form cause to the diverse of meaning.

우리나라 일부 석면사업장의 석면폐 유병률

백도명,백남원,최정근,손미아,임정기,이원진,문영한,박정선,최병순 大韓産業醫學會 1995 대한직업환경의학회지 Vol.7 No.1

Asbestos industry has been in operation over 60 years in Korea. However, the prevalence of asbestosis has not been yet reported. With rapid turn-over of workers, previous cross-sectional studies of current workers on the job could not find cases with exposures long enough for the development of asbestosis. This study was done to evaluate asbestosis prevalence of those worksites with operation history of more than 20 years. In total, 139 workers from 5 worksites were examined. Asbestos industries covered in the study include 2 asbestos textile, 1 brake lining, and 2 ship repairing worksites. Chest x-ray was taken from all workers and read by two experts familiar with pneumoconiosis classification according to 1980 ILO guidelines. Those with findings compatible with asbestosis were further ckecked with high resolution computerized tomography (HRCT). Pulmonary function tests were done according to ATS guidelines, and occupational and previous medical history was taken through a standardized interview. Air-borne asbestos was measured according to NIOSH method 7400. The air-borne asbestos concentrations ranged from 0.2-1.3 f/cc for asbestos textile, from 0.7-1.0 f/cc for brake lining, and from 6.3-7.8 f/cc during asbestos removal at ship repairing worksite. Of the 139 workers 25 had abnormal chest radiographic findings, and 10 of them had findings compatible with pneumoconiosis. When work history and current asbestos measurements were accounted, 9 workers who had more than 10 years of asbestos exposure history showed chest radiographic findings of pneumoconiosis with Finally, 4 workers showed finding of pulmonary fibrosis and/or pleural thickening at HRCT, and 2 of them had restrictive lung function changes. The study results showed that, among 139 subjects, there were 4(3%) definite asbestosis cases confirmed with HRCT. The prevalence of probable asbestosis was 7% for 10-14 years of exposure, 13% for 15-19 years of exposure, and 23% for 20 or more years of exposure. The prevalence of compensable asbestosis with abnormal lung function was 4-6% for those with 15 or more years of exposure.

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.

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.

美術관 建築計劃의 基本理念에 關한 考찰

尹道根 弘益大學校 1971 弘大論叢 Vol.3 No.-

There has been striking tendencies in most of the developing countries that historic traditions were consciously appreared to be preserved since the early Twentieth Century. Fine Arts Museum is aimed to collect, evaluate and exhibit all the concerned materials in such a way that it could culturally contribute to the public, to the extent possible. In terms of function & spatial composition of the museum, every work of arts could properly be displayed into the space where a collective art of spatial architecture is made possible. Many architects and planners have already studied future development of planning approaches for the fine arts museum, and yet urgent need of further analysis and specific research studies is revealed in a series of problems, that could give an inevitable result for particular solution. To this respect, the study report will mainly cover the following aspects; -Understanding the nature and structure of physical composition of recently built museums abroad since last decade, -Developing programmes and planning requirement from the result of case studies for Museums prepared by the writer on the spot during planning research work in the Europe, -Defining goals and objectives of desired future patterns in museum construction and implementing these objectives in plans and proposals.

日本現代建築의 共通的 特性에 관한 硏究

尹道根,李一珩 弘益大學校 1992 弘大論叢 Vol.24 No.2

Contemporary architecture in Japan is entering an entirely new phase in the second half of the 1980s. In the late 1960s, doubts began to be expressed about Modernism, which until then had been the recogniged mainstream of architecture. There was much discussion, but it was only in the early '80s that an active debate was initiated concerning Post-Modernism. Today, however, matters have gone beyond this, and the situation appears particulary significant the Japanese architecture world was hither to understand to be fundamentally very different from its western counterparts. It is also true that many contemporary Japanese architects have reinforced this view that japanese architecture is unknowable by using abjectives such as "mysterious" and "Far Eastern" to describe their works, albeit in part in a metaphorical sense. This was probably due to a communication gap. There are several trends in current Japanese architecture which have still come out of the Japanese tradition of life, culture, region, climate itself. At the same time, stance of comtemporary Japanese architecture start from a common basis in world's design stream which can be called Post-Modernism, Deconsrtuctivism, Neo or New-Modernism. This study is aimed at analysis of common characteristics in comtemporary Japanese architecture.