서울시 관내 노인복지관 이용 노인의 죽음준비교육에 대한 효과

강원남(Kang, Won Nam),유지영(Lyu, Jiyoung) 한림대학교 고령사회연구소 2019 한림고령사회연구 Vol.7 No.1

본 연구는 서울시 관내 노인복지관 이용자들을 대상으로 죽음준비교육 중 사전연명의료의향서 및 호스피스 완화의료를 중심으로 한 단회기 교육이 관련 지식, 죽음태도, 죽음불안 및 삶의 의미에 어떤 영향을 미치는지 살펴보는 것을 목적으로 진행되었다. 실험은 서울시 관내 노인복지관을 이용하는 60세 이상 노인들을 대상으로 진행되었으며, 자발적 참여 의사를 밝힌 노인들을 실험집단 30명과 통제집단 24명으로 나누어 사전 검사 실시 후 실험집단을 대상으로 주 1회, 회기당 90분, 총 3회기에 걸쳐 죽음준비교육을 실시하였으며 교육 후 사후 검사를 실시하였다. 그리고 교육 효과의 지속성을 확인하기 위하여 4주 후 다시 추후 검사를 실시하였다. 통제집단은 죽음준비교육이 이루어지지 않았고 실험집단과 동일하게 사후, 추후 검사만을 실시하였다. 연구 결과 죽음준비교육이 사전연명의료의향서 및 호스피스 완화의료에 대한 내용들을 중심으로 단기적으로 이루어질 경우 관련된 지식과 죽음태도, 죽음불안, 삶의 의미에는 유의미한 변화가 없었으며, 통제집단과 비교했을 때도 유의미한 변화는 없었다. 이와 같은 교육은 사전연명의료의향서 및 호스피스 완화의료에 대해 참여자들에게 적절한 정보를 제공하고, 죽음에 대한 태도에 일부 영향을 줄 수 있으나, 죽음불안과 삶의 의미에 영향을 주는데는 한계가 있음을 시사한다. 이상의 결과를 통해 사전연명의료의향서 및 호스피스 완화의료를 중심으로 한 단회기 교육이 노인의 관련 지식 및 죽음불안, 죽음태도, 삶의 의미에 미치는 영향을 알아볼 수 있었으며, 죽음준비교육 진행 시 고려해야 할 구성별, 내용별, 회기별 적절성과 향후 죽음준비교육이 나아가야 할 방향성에 대하여 확인하였다. This study was performed to examine the effect of short-term death education focused on Advanced Directives and Hospice Palliative Care on the related knowledge, Attitude about Death, Death Anxiety, and Meaning of Life of the elderly in the senior welfare centers in Seoul. The experiment was conducted among the elderly over 60 years of age in senior welfare centers in Seoul. The participants were divided into two groups, such as 30 subjects for the experimental group and 24 subjects for the control group. All participants had pre-tests before the education. Three sessions of 90-minute Death Education were conducted once a week and post-tests were conducted after the education. In order to confirm the continuity of the educational effect, the follow-up tests were performed after 4 weeks. The control group did not receive death education, but they had the same post-tests and follow-up tests. The study results showed that there was no significant change in the related knowledge, Attitude about Death, Death Anxiety, and Meaning of Life when Death Education focusing on Advanced Directives and Hospice Palliative Care was conducted in a short-term. The education can provide participants with relevant information about Advanced Directives and Hospice Palliative Care, and may have some impact on their attitudes toward death. However, the impacts on Death Anxiety and Meaning of Life may be limited. In this study, the effect of a short-term education centered on Advanced Directives and Hospice Palliative Care on the related knowledge, Death Anxiety, Attitude about Death, Meaning of Life of the elderly was examined. Based on the study results, the composition, content, and the number of sessions for the appropriate Death Education were suggested.

국소적으로 진행된 자궁경부암의 방사선치료와 복합 항암화학요법의 동시치료 결과

강원철(One Chul Kang),최은경(Eun Kyung Choi),정원규(Weon Kuu Chung),김종훈(Jong Hoon Kim),장혜숙(Hyesook Chang),김용만(Yong Man Kim),김영탁(Young Tak Kim),남주현(Joo Hyun Nam),목정은(Jung-Eun Mok),이무송(Moo-Song Lee) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.3

목 적 : 국소적으로 진행된 자궁경부암환자에서 방사선 치료와 5-FU, CDDP 복합항암요법의 동시 치료에 의한 종양관해율, 치료부작용, 예후인자, 실패양상과 생존율을 분석하기 위하여 전향적 제 2상연구를 시행하였다. 대상 및 방법 : 울산대학교 서울중앙병원 방사선종양학과와 산부인과에서 1992년 5월부터 1997년 1월까지 FIGO병기 IIB, III, IVA의 국소적으로 진행된 자궁경부암으로 진단받고 치료한 환자 73명중 방사선치료와 동시에 2회의 FP 항암요법을 시행한 68명을 대상으로 분석을 시행하였다. FIGO병기에 의한 분포는 IIB 46명, IIIA 2명, IIIB 15명, IVA 5명이었고, 이들의 연령분포는 31세에서 77세까지로 중앙값 58세이었다. 방사선치료시 외부조사는 전골반부에 4,140-5,040 cGy를 시행후 192Ir 고선량 근접치료기로 주 3회씩 6-7회의 강내조사를 시행하며 동시에 B점추가조사를 시행하여 A점에 7,500-8,000 cGy, B점에 6,000-6,500 cGy가 되도록 조사하였다. FP (5-FU;1,000mg/m2/24 hours, 4 days+CDDP; 20mg/m2/3 hours, 3 days) 항암화학요법은 방사선치료 시작 제 1일과 제 29일에 각각 4일간 투여하도록 하였다. 치료효과는 치료종료시점과 치료후 1개월, 3개월에 시행한 부인과 검사와 MRI로 판정하였다. 결 과 : 전체 환자의 추적기간은 4개월에서 68개월 (중앙값 24개월)이었다. 생존율을 분석한 환자 64명의 5년생존율 및 무병생존율은 각각 52%와 64%였으며, FIGO병기 IIB인 환자의 5년생존율과 무병생존율은 각각 58%, 71%이었고, FIGO병기 III와 IVA인 환자는 각각 36%, 46%이었다. 재발양상은 전체 재발율이 27.9% (19/68)로, 국소재발이 5.9% (4/68), 원격전이가 10.3%(7/68), 국소재발과 원격전이가 같이 있는 경우가 11.8% (8/68)로 나타났다. 치료종료 한달 후 치료 효과를 판정할 수 있었던 64명중 78% (50/64)가 완전관해를 보였다. 예후인자는 단변량분석시 5년생존율에 FIGO병기, 치료반응율, 골반내와 대동맥주위 림프절 전이유무가 통계적으로 의미 있었고, 다변량분석시 치료반응율과 치료중 혈색소 농도가 통계적으로 의의있게 나타났다. 치료에 따른 독성은 10%내외로 치료후 대부분 자연 회복되었으나, 2차 항암약물투여중 폐부종이 발생한 1명과 치료종료후 8개월에 만성합병증인 장천공이 발생한 1명은 치료에 따른 부작용으로 사망하였다. 결 론 : 국소적으로 진행된 자궁경부암에 대한 방사선치료와 복합항암요법의 동시치료는 수용 가능한 독성을 보였고, 진행된 경우 생존율의 향상을 관찰할 수 있었다. 좀 더 장기적인 추적관찰 후 여러 예후인자들을 고려하여 초기 치료반응율을 높이는 치료방법의 선택이 필요하리라 생각되며, 동시 방사선-항암화학요법의 종양관해율과 생존율의 차이를 알아보기 위한 제 3상 무작위 연구가 필요한 것으로 생각된다. Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From May 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/m2/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/m2/day intravenous bolus for 3 days, day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow -up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol; The 5-year actuarial and disease-free survival rate were 52% and 64%, respectively. The 5-year actuarial survival for stage IIB and III+IVA patients were 58% and 36%, respectively. The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71% and 46%, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9% (19/68): local failure in 5.9% (4/68), distant metastasis in 10.3% (7/68) and both in 11.8% (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment, the complete response rate was 78% (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow -up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

PLD법을 이용한 다양한 온도에서의 $FeSe_x$ 초전도 박막 성장

정순길,이남훈,강원남,황태종,김동호,Jung, Soon-Gil,Lee, N.H.,Kang, W.N.,Hwang, Tae-Jong,Kim, D.H. 한국초전도학회 2011 Progress in superconductivity Vol.13 No.2

We have fabricated $FeSe_x$ superconducting thin films at much different substrate temperatures of 430 and $610^{\circ}C$ on $Al_2O_3$(0001) substrates by using a pulsed laser deposition (PLD) technique. Superconducting transitions for both films were shown around 10 K, but their transition width and growth directions of grains were different. We found that superconducting tetragonal FeSe phases and non-superconducting hexagonal FeSe phases were coexisted in the sample grown at the low temperature of $430^{\circ}C$, whereas the hexagonal FeSe phase was decreased with increasing fabrication temperatures.

다양한 조건에서의 $Ba_{1-x}K_xFe_2As_2$ 박막 제조

이남훈,정순길,강원남,Lee, Nam-Hoon,Jung, Soon-Gil,Kang, Won-Nam 한국초전도학회 2010 Progress in superconductivity Vol.12 No.1

Potassium doped $BaFe_2As_2$ superconducting thin films by using an ex situ pulsed laser deposition technique were fabricated in various conditions to find out an optimal growth condition. Controlled conditions were annealing temperature, annealing time, and mass of potassium. The $Ba_{1-x}K_xFe_2As_2$ thin films which has most good quality is fabricated at a condition of annealing temperature at $700^{\circ}C$, annealing time of 60 minutes, and 0.6 g of potassium lumps. In this condition we were able to fabricate good quality films with high transition temperature of ~ 39 K.

Mixed-state Hall effect of $MgB_2$ thin films

김보연,정순길,문경희,강원남,최은미,김헌정,이성익,김형진,Kim, Bo-Yeon,Jung, Soon-Gil,Moon, Kyeong-Hee,Kang, W.N.,Choi, Eun-Mi,Kim, Heon-Jung,Lee, Sung-Ik,Kim, Hyeong-Jin The Korean Superconductivity Society 2006 Progress in superconductivity Vol.7 No.2

We have measured the Hall resistivity (${\rho}_{xy}$) and the longitudinal resistivity (${\rho}_{xy}$) on superconducting $MgB_2$ thin films in extended fields up to 18 T. We found a universal scaling behavior between the Hall resistivity and the longitudinal resistivity, which is independent of the temperature and the magnetic field. At a wide magnetic field region from 1 to 18T, a universal power law of ${\beta}=2.0{\pm}0.1$ in a scaling relation, ${\rho}_{xy}={A{\rho}_{xx}}^{\beta}$, was observed in c-axis-oriented $MgB_2$ thin films. These results can be well interpreted by using recent models.

$MgB_2$ 초전도 박막의 경이온 조사에 의한 효과

이남훈,성원경,김소연,박성하,강원남,Lee, N.H.,Seong, W.K.,Ranot, Mahipal,Kim, So-Yeon,Park, Sung-Ha,Kang, W.N. 한국초전도학회 2009 Progress in superconductivity Vol.11 No.1

We investigated the effects of the irradiation of light-ions on the superconducting $MgB_2$ thin films fabricated by using HPCVD. Deuterium and helium ions were irradiated on $MgB_2$ thin films by various doses, from $1{\times}10^{10}cm^{-2}\;to\;8{\times}10^{15}cm^{-2}$. During these experiments some reasonable results and unpredictable results have been obtained. The reasonable results are that the peak of the reduced maximum pinning force shifts by increasing the pinning sites in $MgB_2$ films and the slightly change of critical current density of films. We obtained some unusual results, which are the increasing of the transition temperature and the change of residual resistance ratio. Among the data of deuterium and helium ion irradiation experiments, the results of helium ion irradiation have most notable points so we will discuss mainly about helium irradiation experiments.

혼성물리화학기상 증착법으로 여러가지 불순물층 위에 제조한 $MgB_2$ 박막에 대한 연구

박세원,성원경,정순길,강원남,Park, S.W.,Seong, W.K.,Jung, Soon-Gil,Kang, W.N. 한국초전도학회 2008 Progress in superconductivity Vol.10 No.1

By using the hybrid physical-chemical vapor deposition (HPCVD) technique, we have fabricated $MgB_2$ thick films on $Al_{2}O_3$ substrates with various impurity layers of Ni, Ti, and SiC. We have found a significant enhancement of the critical current density ($J_c$) for $MgB_2$ films grown on impurity layered substrates, indicating that additional impurity layers were provided as possible pinning sites by chemical doping in $MgB_2$ films. All samples doped by Ni, Ti, and SiC were observed to have high superconducting transition temperatures of 39 - 41 K. The $J_c$ of $MgB_2$ films grown on SiC impurity layered substrates showed three times higher than that of undoped films at high magnetic fields above 1 T.

Properties of $MgB_2$ Intragrain Nanobridges

홍성학,이순걸,성원경,강원남,김동호,김영국,정국채,Hong, Sung-Hak,Lee, Soon-Gul,Seong, Won-Kyung,Kang, Won-Nam,Kim, Dong-Ho,Kim, Young-Kuk,Chung, Kook-Chae The Korean Superconductivity Society 2009 Progress in superconductivity Vol.10 No.2

Inter-grain nanobridges of the $MgB_2$ superconductor have been fabricated by focused-ion-beam(FIB) and their electrical transport properties were studied. The $MgB_2$ film was prepatterned into microbridges by a standard argon ion milling technique and then FIB-patterned into 100 nm$\times$100 nm bridges. Current-voltage characteristics showed a strong flux-flow type behavior at all temperatures with a trait of Josephson coupling near $T_c$. At low temperatures, the curves showed a two-step resistance-doubled transition with occasional hysteresis. The resistance-doubling transition is believed to be due to a two-channel flux-flow effect. The temperature-dependent critical current data showed $I_c(T){\propto}(1-T/T_c)^2$ near $T_c$, same as a normal barrier junction, and $I_c(T){\propto}(1-T/T_c)^{1.2}$ at low temperatures, similar to that of a film.

$MgB_2$ 초전도 박막의 홀 전도도의 온도 의존성

정순길,성원경,허지영,이태경,강원남,최은미,김형진,이성익,Jung, Soon-Gil,Seong, W.K.,Huh, Ji-Young,Lee, T.G.,Kang, W.N.,Choi, Eun-Mi,Kim, Hyeong-Jin,Lee, Sung-Ik 한국초전도학회 2007 Progress in superconductivity Vol.8 No.2

We have measured the Hall conductivity (${\sigma}_{xy}$) of c-axis-oriented $MgB_2$ thin films as functions of temperatures and magnetic fields. We found that the Hall conductivity (${\sigma}_{xy}$) is expressed by the sum of two terms, ${\sigma}_{xy}=C_l/H+C_3H$, where the coefficient $C_1\;and\;C_3$ are independent of the magnetic fields and have positive values. The coefficient $C_1$ is strongly dependent on the temperature, while the $C_3$ is weakly dependent on the temperature. We have obtained that the $C_1$ is proportional to $(1- T/T_c)^n$ with n = 4.2, which is consistent with the data observed in $La_{2-x}Sr_xCuO_4$ superconductors with low anisotropy ratio.

HPCVD 방법으로 성장된 $MgB_2$ 박막의 수송 특성

김혜영,황태종,김동호,성원경,강원남,Kim, Hye-Young,Hwang, Tae-Jong,Kim, D.H.,Seong, Won-Kyung,Kang, W.N. 한국초전도학회 2007 Progress in superconductivity Vol.9 No.1

We prepared four different $MgB_2$ films on $Al_2O_3$ by hybrid physical chemical vapor deposition method with thicknesses ranging from $0.65\;{\mu}m$ to $1.2\;{\mu}m$. X-ray diffraction patterns confirm that all the $MgB_2$ films are c-axis oriented perpendicular to $Al_2O_3$ substrates. The superconducting onset temperature of $MgB_2$ films were between 39.39K and 40.72K. The residual resistivity ratio of the $MgB_2$ films was in the range between 3.13 and 37.3. We measured the angle dependence of critical current density ($J_c$) and resistivity, and determined the upper critical field ($H_{c2}$) from the temperature dependence of the resistivity curves. The anisotropy ratios defined as the ratio of the $H_{c2}$ parallel to the ab-plane to that perpendicular to the ab-plane were in the range of 2.13 to 4.5 and were increased as the temperature was decreased. Some samples showed increase of $J_c$ and decrease of resistivity when a magnetic field in applied parallel to the c-axis. We interpret this angle dependence in terms of enhanced flux pinning due to columnar growth of $MgB_2$ along the c-axis.