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>

소형민수헬기 능동진동제어시스템 개발

김남조(Nam-Jo Kim),곽동일(Dong-Il Kwak),강우람(Woo-Ram Kang),황유상(Yoo-Sang Hwang),김도형(Do-Hyung Kim),김찬동(Chan-Dong Kim),이기진(Ki-Jin Lee),소희섭(Hee-Soup So) 한국항공우주학회 2022 韓國航空宇宙學會誌 Vol.50 No.3

헬기의 능동진동제어시스템(AVCS)은 주로터로부터 발생되는 진동을 제어하며, 수동형 진동저감장치 대비 저중량으로 우수한 진동저감 성능을 발휘한다. 본 논문에서는 FxLMS 알고리즘을 기반으로 타코미터 및 가속도 센서 신호를 통해 연산된 제어명령을 하중발생기(CFG)로 전달하여 소형 민수헬기의 진동을 제어하는 소프트웨어 개발 및 검증 내용을 제시하였다. DO-178C /DO-331 표준에 따라 모델 기반 설계 기법을 통해 진동제어 소프트웨어를 개발하였으며, PILS 및 HILS 환경에서 실시간 작동 성능을 평가하였다. 특히, PILS 환경에서는 LDRA 기반 검증 커버리지를 통해 소프트웨어의 신뢰성을 향상시켰다. AVCS를 소형민수헬기에 적용하기 위해 지상/비행시험을 통해 대상 헬기 동적응답특성 모델을 획득하였다. 이를 기반으로 시스템 최적화 분석 및 비행시험을 통해 최적 성능을 발휘하는 AVCS 형상을 결정하고, STC 인증을 획득하였다. Active vibration control system(AVCS) for helicopter enables to control the vibration generated from the main rotor and has the superb vibration reduction performance with low weight compared passive vibration reduction device. In this paper, FxLMS algorithm-based vibration control software of the light civil helicopter tansmits the control command calculated using the signals of the tachometer and accelerometers to the circular force generator(CFG) is developed and verified. According to the RTCA DO-178C/DO-331, the vibration control software is developed through the model based design technique, and real-time operation performance is evaluated in PILS(processor in-the loop simulation) and HILS(hardware in-the loop simulation) environments. In particular, the reliability of the software is improved through the LDRA-based verification coverage in the PIL environments. In order to AVCS to light civil helicopter(LCH), the dynamic response characteristic model is obtained through the ground/flight tests. AVCS configuration which exhibits the optimal performance is determined using system optimization analysis and flight test and obtain STC certification.

만성두통 환자의 성격유형 A 행태, 스트레스, 우울 및 두통영향정도의 관계 연구

차남현,임사비나,정인태,김수영,안경애,김건식,이재동,이상훈,최도영,이윤호,이두익 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

To examine an estimate factor and grasp the relation of difference for Ype A Behavior Pattern(TABP), Perceived Stress Questionnaire. Depression and HIT-6 in the Chronic headache client. Method: Data collected by self-reported questionnaires from 38 client in S city who were selected by criteria of IHS, from the 19^(th) of October to 10^(th) of December, 2004. Result: 1) Differences between biographical data by TABP was significant by SaSang constitutions, by Stress was significantly influenced by age, and by Depression were significantly influenced health status and SaSang constitutions. 2) Correlations Coefficients among Study Variables were Stress and Depression(r=.494, p=.002) and Depression and HIT-6(r=.432, p=.010). 3) In regression analysis, HIT-6 were significantly influenced by Depression and Type A Behavior Pattern(TABP). These variables explained 38% and 34% respectively. Conclusion: The result suggest that chronic headache management with psychological aspect, as well as physical aspect should be a focus to enhance the quality of life.

침 치료가 오십견(五十肩) 환자의 적외선 체열촬영에 미치는 영향

김건형,이로민,남동우,김종인,임사비나,이두익,최도영,이윤호,이재동 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

Objectives : To observe the effect of acupuncture treatment on Digital Infrared Thermographic Imaging(DITI) in frozen shoulder patients. Methods : 17 voluntary patients received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwanand Gyun-joong, twice a week for 4 weeks. The patients were instructed to practice self exercise during their daily lives. Evaluations were made before treatment, after 1 week of treatment, after 2 weeks, 3 weeks and after 4 weeks of treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). DITI was measured before treatment and after 4weeks of treatment. The obtained data was analyzed. Results : CSA, SPADI, VAS, adduction and extension showed significant(p<0.05) improvement. Abduction and flexion both improved after 4 weeks of treatment, but the improvement was statistically insignificant(p>0.05). DITI showed improvement but the improvement was insignificant(p>0.05). Conclusion : 4 weeks of acupuncture treatment significantly improved CSA, SPADI, VAS, adduction and extension in frozen shoulder patients(p<0.05). The improvement of abduction and flexion after 4 weeks of acupuncture treatment was insignificant(p>0.05). DITI results improved after 4 weeks of acupuncture treatment. But the change of thermal difference was insignificant(p>0.05).

만성두통환자에 대한 동서협진의 임상적 연구

정인태,이상훈,김수영,차남현,김건식,이두익,이재동,임사비나,이윤호,최도영 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : Because the cause and etiology of chronic headache are not yet fully explained, the treatment of this symptom is not simple. In order to study the effectiveness East-West pain treatment on chronic headache, we evaluated its effect of pain alleviation and quality of life improvement on chronic headache patients who were treated with nerve block and acupuncture, and only acupuncture for eight weeks. Methods : 92 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as chronic headache patients. The qualified patients were classified into two groups, nerve block and acupuncture group(EW group, n=49) and acupuncture group(E group, n=43). Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes. The effects of two groups were analyzed using VAS scores and BPI(Brief Pain Inventory). Results : The VAS and BPI after four weeks of treatment showed significant improvement among two but differences between the three groups was statistically insignificant. The VAS and BPI of the EW group after eight weeks of treatment showed statistically significant improvement compared to the other two groups. Conclusion : The pain treatment for chronic headache might be contributed to improvement of quality of life as well as alleviation of pain of chronic headache patients. It was suggested that the West pain treatment in combination with East pain treatment might be an useful modality to improve the pain and quality of life in chronic headache patients.

만성두통환자에 대한 침치료가 심박변이도에 미치는 영향

정인태,이상훈,김수영,차남현,김건식,이두익,이재동,임사비나,이윤호,최도영 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The purpose of this study was to assess the effect of acupuncture treatment for chronic headache patients using power spectrum analysis of the heart rate variability(HRV). Methods : 15 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as Chronic Headache patients. Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes. The effects of acupuncture treatment were analyzed using power spectrum analysis of the HRV, HRV was recorded before and after acupuncture treatment. Results : HRV before and after treatment was compared after 8 weeks of acupuncture treatment. Increase in mean values of SDNN and RMSSD were observed but the increases were not statistically significants. Increase in mean values of TP, LF and HF were observed but, the increase was significant(p<0.05) only in TP. Conclusions : The results suggest that acupuncture treatment on chronic headache patients can increase the activity of autonomic nervous system. Further use of HRV for quantitative analysis of acupuncture treatment on autonomic nervous system related symptoms is suggested.

주사 전자현미경을 통하여 확인된 단락관내 소집락 형성 : 증례보고 Case Report

남도현,왕규창,이현구,조병규 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10

Two patients who had bacterial colonies in shunt catheter confirmed by scanning electron microscopy(SEM) are described Coagulase negative staphylococcus had been cultured persistently from ventricular cerebrospinal fluid in spite of adequate medical treatment for shunt infection and the normalized profile of the cerebrospinal fluid. The authors controlled the shunt infection by removal of shunt catheters. Based on these SEM findings, it is mandatory to remove an infected shunt and replace it with a new one after proper antimicrobial therapy in cases with persistently positive culture.

순시 공진 전압 합성형 DC-DC 컨버터에 관한 연구

이상호,이봉섭,정도영,황계호,남승식,노채균 嶺南大學校 工業技術硏究所 1998 工業技術硏究所論文集 Vol.26 No.2

This paper describes a DC-DC converter connected two unit inverters, a half-bridge high frequency resonant inverters, at the input with parallel. It estimated characteristics such as the average power, the average output voltage etc, for the design of the device with the normalized parameter values. Also, This paper confirms a rightfulness of circuit analysis by comparing a simulation and experimental results of proposal converter. The proposed paper certified that the theoretical waveforms are equal to the experimental waveforms. In the future, it is expected that proposal converter can be applicated for the system of fixed DCvoltage source.

유착성 관절낭염에 대한 침 및 신경차단술 처치의 임상적 관찰

남동우,임사비나,김종인,김건식,이두익,이재동,이윤호,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2007 東西醫學硏究所 論文集 Vol.2007 No.-

Objectives : To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Metbods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group ,n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW grouP, n=20). The E group received acupuncture treatment on LI15, TE_(14), GB_(21) and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. AU three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significant1y(P<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.