• Title/Summary/Keyword: 단일 완화 시간

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Current Situation on Signing Advance Medical Directives and Actual Life-sustaining Treatment Given at a University Hospital (일개 대학병원의 연명치료 선택 및 사전의료의향서 작성 현황)

  • Yoon, Ho-Min;Choi, Youn-Seon;Hyun, Jong-Jin
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.91-100
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    • 2011
  • Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

English Phoneme Recognition using Segmental-Feature HMM (분절 특징 HMM을 이용한 영어 음소 인식)

  • Yun, Young-Sun
    • Journal of KIISE:Software and Applications
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    • v.29 no.3
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    • pp.167-179
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    • 2002
  • In this paper, we propose a new acoustic model for characterizing segmental features and an algorithm based upon a general framework of hidden Markov models (HMMs) in order to compensate the weakness of HMM assumptions. The segmental features are represented as a trajectory of observed vector sequences by a polynomial regression function because the single frame feature cannot represent the temporal dynamics of speech signals effectively. To apply the segmental features to pattern classification, we adopted segmental HMM(SHMM) which is known as the effective method to represent the trend of speech signals. SHMM separates observation probability of the given state into extra- and intra-segmental variations that show the long-term and short-term variabilities, respectively. To consider the segmental characteristics in acoustic model, we present segmental-feature HMM(SFHMM) by modifying the SHMM. The SFHMM therefore represents the external- and internal-variation as the observation probability of the trajectory in a given state and trajectory estimation error for the given segment, respectively. We conducted several experiments on the TIMIT database to establish the effectiveness of the proposed method and the characteristics of the segmental features. From the experimental results, we conclude that the proposed method is valuable, if its number of parameters is greater than that of conventional HMM, in the flexible and informative feature representation and the performance improvement.

Information Appliance Control MultiAgentsystem (정보가전 제어 멀티에이전트시스템)

  • 김일연;송준현;김일곤
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2002.11a
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    • pp.363-369
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    • 2002
  • 가정 내에서의 초고속망 이용이 활성화되면서 가정 내에서의 활동은 매우 다양하고 복잡하며 그에 따른 서비스도 여러 가지 형태가 존재한다. 외부 인터넷망과 연동되는 홈 네트워크의 개념이 생기기 전부터 흠 오토메이션, 홈시큐리티 등의 서비스를 제공하기 위한 고립적인 형태의 망과 서비스 제공 시스템이 있었다. 월드 와이드 웹 서비스를 기본으로 한 인터넷의 폭발적인 활성화와 고속 인터넷망의 확산에 따라 가정 내에서 제공되는 서비스를 인터넷과 연계시키려는 시도가 보편화되었고 가정 내에서 사용되는 독립적인 기기들을 인터넷에 연결하여, 외부의 정보를 이용해서 활용하거나, 가전내의 기기들을 외부에서 액세스할 수 있게 되었다. 이렇게 하여 보다 풍부한 서비스를 제공하고, 사용상의 시간적인 제약을 완화할 수 있다. 예들 들어 인터넷상에서 조리법을 전송받아 전자레인지를 작동할 수 있으며, 외부에서 잘못 켜둔 가스밸브를 잠글 수도 있다. 가정 내에서 wrhd되던 이러한 서비스들은 서로 다른 하드웨어와 통신방법을 사용하고 있어, 이러한 서비스를 통합하여 운영, 관리할 수 있도록 하는 흠 서버의 개념이 대두되었다. 외부 인터넷 망과 연계된 흠 오토메이션, 홈 시큐리티등을 제공할 수 있는 기반이 마련되었고, 가정 내에서 독립적으로 제공되던 서비스들을 단일 홈 서버를 통해서 관리하려는 시도가 진행되었다. 그러나 홈 서버는 개발하는 업체의 보유기술에 따라 중심기능은 약간씩 차이를 보이고 있다. 홈 서버 응용 영역은 전문 지식을 소유한 인력과의 연계가 필요하고, 다양한 서비스 영역 행위가 아주 복잡하기 때문에 이들을 연결해 주는 자치 시스템을 필요로 한다. 또한 홈 서버 서비스 영역에서 정보는 각 영역 전문가가 가진 지식의 전달을 필요로 하기 때문에, 지식을 주고받는 멀티 에이전트의 시스템의 활용 영역으로 적당하다. 멀티 에이전트 시스템은 분산된 환경에서 에이전트간에 에이전트 통신 언어를 사용해서 대화를 하기도 하고, 상호 협력하는 에이전트들로 구성된 시스템을 뜻하며 흠 서버처럼 동적이고 고도의 자치성을 요구하는 영역에 적당하다. 멀티 에이전트 플랫폼으로는 FIPA(Foundation for Intelligent Physical Agents)가 제시한 에이전트 표준 플랫폼이 1997년부터 2000년에 이르기까지, 계속적으로 변화, 발전하고 있다. 본 연구는 FIPA에서 제시하는 플랫폼을 기반으로 홈 서버에 정보가전을 제어하는 에이전트를 두고 외부에서 다른 에이전트가 홈 서버에 위치하는 에이전트와의 통신을 통하기 정보가전을 지능적으로 제어하도록 하였다. 정보가전 에이전트는 가정 내 가전제품을 외부에서 제어하기 위한 에이전트이다. 단순한 관리가 아닌 에이전트로 하여금 지능적으로 가전제품 관리를 하게 한다. 정보가전 에이전트는 홈 서버에서 작동하는 에이전트와 PDA에서 작동하는 에이전트로 구성된다. 정보가전 에이전트는 전력량, 수도 사용량 제어와 가전제품 제어 기능과 보안 관련 서비스를 제공한다. 두 에이전트는 FIPA에서 정의된 규격에 맞게 만들어지기 때문에 FIPA명세서를 따르는 다른 에이전트와 자유로운 통신이 가능하다.

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Study of Subjective View on the Meaning of Well-dying Held by Medical Practitioners and Nursing Students: Based on Q-Methodology (의료인과 간호학생의 웰다잉 의미에 관한 주관성 연구)

  • Kim, Seon Young;Hur, Sung Soun;Kim, Boon Han
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.10-17
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    • 2014
  • Purpose: This study was conducted to examine understanding of the meaning of well-dying and types of such views held by medical practitioners and nursing students. Methods: The Q-methodology was used to analyze the subjectivity of each item. The P-sample was made up of 22 medical practitioners or nursing students. The P-sample was instructed to rate 33 statements using a 7-point scale to obtain forced normal distribution. They were asked to make extra comments on the statements that were placed on both ends of the distribution curve. The PC-QUANL Program was used for the factor analysis of the collected data. Results: The participants had three types of meaning of well-dying. Total variance explained by these types was 57.97%" where type 1 was "reality-oriented", type 2 "relationship-oriented" and type 3 "obeying-the-nature". Conclusion: The participants' subjective views on well-dying influences their medical practice on patients who are facing death. Therefore, medical practitioners should have profound insights concerning life and death. To that end, a training program is needed to help medical practitioners develop a proper view on well-dying by subjectivity type.

A Study on the Theory of $\frac {1}{f}$ Noise in Electronic Devies (전자소자에서의 $\frac {1}{f}$잡음에 관한 연구)

  • 송명호
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.3 no.1
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    • pp.18-25
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    • 1978
  • The 1/f noise spectrum of short-circuited output drain current due to the Shockley-Read-Hal] recombination centers with a single lifetime in homogeneous nondegenerate MOS-field effcte transtors with n-type channel is calculated under the assumptions that the quasi-Fermi level for the carriers in each energy band can not be defined if we include the fluctuation for time varying quantities. and so 1/f noise is a majority carrier effect. Under these assumptions the derived 1/f noise in this paper show some essential features of the 1/f noise in MOS-field effect transistors. That is, it has no lowfrequency plateau and is proportionnal to the channel cross area A and to the driain bias voltage Vd and inversely proportional to the channel length L3 in MOS field effect transistors. This model can explain the discrepancy between the transition frequency of the noise spectrum from 1/f- response to 1/f2 and the frequency corresponding to the relaxation time related to the surface centers in p-n junction diodes. In this paper the results show that the functional form of noise spectrum is greatly influenced by the functional forms of the electron capture probability cn (E) and the relaxation time r (E) for scattering and the case of lattice scattering show to be responsible for the 4 noise in MOS fold effect transistors. So we canconclude that the source of 1/f noise is due to lattice scattering.

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Antiemetic Effect of Dolasetron Mesylate in the Prevention of Acute and Delayed Nausea and Vomiting due to Moderately Emetogenic Chemotherapy (악성종양환자에서 중등도 이상의 오심, 구토를 유발하는 항암화학요법 시급성 및 지연성 오심, 구토의 예방에 대한 Dolasetron의 효과)

  • Kim, D.S.;Sung, H.Y.;Choi, K.M.;Paik, J.Y.;Roh, S.Y.;Moon, H.;Kim, C.C.;Hong, Y.S.
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.248-257
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    • 2004
  • Purpose: To evaluate the efficacy of dolasetron mesylate in controlling nausea and vomiting in the first 24 hours and to extend these comparisons over the next 4 days in patients receiving moderately emetogenic chemotherapy. Methods: This was a single center, open-labeled study with single arm. Dolasetron (1.8 mg/kg) was given intravenously (I.V.) prechemotherapy with 10 mg of dexamethasone IV, followed 24 hours later by oral dolasetron (200 mg once daily) for the subsequent 4 days. The frequency of vomiting, severity of nausea and the presence of rescue antiemetics were assessed daily. Results: Of 30 patients enrolled, 28 were eligible and evaluable for the efficacy. Four out of 28 patients had complete control of nausea and vomiting without any rescue antiemetics through 5 days. The complete control got better as time went by with the rates of 17.9/46.4/42.9/53.6/60.7% on days 1 to 5. Vomiting was better controlled than nausea in both cisplatin-containing and non-containing chemotherapy. The adverse events were mild to moderate degrees of headache, diarrhea and fever, but were recovered spontaneously. Conclusion: Dolasetron was effective and safe for the control of nausea and vomiting in the patients with moderately emetogenic chemotherapeutic agents.

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Young Rabbit Model for Pathophysiologic Study of Acute Lung Injury in Early Childhood (유아기 급성폐손상 병태생리 연구를 위한 어린 토끼 실험모델)

  • 권영민;최석철;박종원;김양원;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.545-558
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    • 2003
  • Adult respiratory distress syndrome (ARDS) is of particular interest because of its severity of the associated lung injury and its high mortality. However, the pathophysiologies of ARDS in infant and childhood groups are still not well clarified inspite of many previous investigations. To investigate the time course of pathophysiology of ARDS in infant and childhood groups, this study was designed with experimental endotoxin-induced ARDS model using young rabbits (8 week-old). Material and Method: Rabbits were divided into the control group (n=8) and the endotoxin-treated group (n=32). The endotoxin group was subdivided into 4 groups by the sampling times as 3, 6, 12 and 24 hr-groups (G- $E_{3,6,12,24,}$ each n=8). The experimental ARDS was made by a bolus injection of endotoxin (Escherichia coli serotype 055 : B5, 0.50 mg/kg) via rabbit ear vein. For evaluation of the hematologic and inflammatory markers, and superoxide dismutase (SOD) concentrations, the blood samples were taken from the heart. The bronchoalveolar lavage fluid (BALF) were obtained for analysis of the leukocytes and protein concentration. With biopsy of the lung, histopathologic changes of the lung were also evaluated. Result: In the endotoxin groups, significant leukopenia (owing to pancytopenia) occurred in 3 and 6-hr groups, which was followed by significant leukocytosis (owing to neutrophilia) in the 12 and 24-hr groups (p<0.05). Serum levels of tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and interleukin-1 $\beta$ (IL-1 $\beta$) in the endotoxin groups were higher than those of control group (p<0.05). Serum levels of superoxide dismutase (SOD) of G- $E_{3}$ and G- $E_{6}$ were higher than those of control group, whereas those of G- $E_{12}$ were lower than those of control groups (p<0.05). Total leukocyte counts and protein con-centrations in BALF were significantly elevated in the endotoxin groups compared to the control group (p < 0.05). The hemorrhagic pattern of BALF showed occurred in the endotoxin groups. The endotoxin groups (in G- $E_{6}$) had severe infiltration of inflammatory cells (lymphocyte and monocyte) in the pulmonary interstitium and parenchyma, migrations of neutrophil and eosinophil into alveolar spaces and interstitial widening, which are the evidences of acute lung injury. In the endotoxin groups, there were significant positive correlations between the BALF findings and the immunologic markers (TNF-$\alpha$, IL-1$\beta$, SOD) (p<0.05). Conclusion: Severe acute lung injury occurred in all the endotoxin-treated rabbits. The pathophysiologic findings were so progressive until 6-hr by time dependant pattern, and then recovered slowly, Variable hematologic, immuno-logic, and pathologic factors were well correlated in the development and progression of endoxin-induced lung injury. The pathophysiologic responses were sensitive and rapid in young rabbit Young rabbit seemed to be a useful experimental animal model for infant and childhood groups.roups.

Processing optimization of soybean sprouts pre-treatment for manufacturing frozen Kongnamul-Bibimbap product (냉동 콩나물 비빔밥 제조를 위한 전처리 공정 최적화)

  • Lee, Eun-Jung;Ramachandraiah, Karna;Hong, Geun-Pyo
    • Korean Journal of Food Science and Technology
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    • v.50 no.2
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    • pp.186-190
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    • 2018
  • This study was investigated changes of physical properties of soybean sprout by changing single or combinations of parameters in each manufacturing process. In blanching, use of sugar solution and decrease of blanching time reduced hypocotyl diameter and weight loss of soybean sprouts. However, single application among parameters in pre-treatment did not induce significant changes in soybean sprout during cooking of frozen product. The control process was blanching with water, seasoning with salt and sugar, and adding cooked rice with mixing type. Combinations of parameters, which were blanching with sugar solution, seasoning with sugar, and adding cooked rice with topping type, induced significantly higher shear force values ($592{\pm}21g$), larger diameter ($1.58{\pm}0.14mm$), and less weight loss ($13.4{\pm}3.0%$) of soybean sprouts during cooking of frozen product than those from the control process ($498{\pm}24g$, $1.35{\pm}0.13mm$, and $16.0{\pm}1.7%$, respectively) (p<0.05).

The Analysis of Elasto-Plastic Thermal Stresses for Welding Part in Double Capstan Drum (더블 캡스턴 드럼의 용접부에 대한 탄소성 열응력해석)

  • 김옥삼
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.36 no.4
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    • pp.329-336
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    • 2000
  • Welding is a important technological method in mechanical engineering. $CO_2$MAG(metal active gas) welding means that metal part in double capstan drum for the inshore and costal vessels are joined by melting(with or without a filler material) or that new material is added to a metal part by melting. The thermal stresses appear due to a non-uniform temperature field, inhomogeneous material properties, external restraint and volume changes during phase transformations. In this study analysis the elasto-plastic thermal stresses distribution of welding part in double capstan drum for the inshore and costal vessels using finite element method (FBM). Therefore it calculates the numerical value that can be applied to the optimum design of welding parts and the shapes. The significant results obtained in this study are summarized as fellows. At early stage of the cooling after welding process, the abrupt thermal stresses gradient has been shown in the vicinity of welding part. In the thermal stresses analysis due to temperature gradient and heat shocking maximum stress was occurred of welding part and stresses were distributed from 54MPa~48MPa.

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Development and Evaluation of a Scenario for Simulation Learning of Care for Children with Respiratory Distress Syndrome in Neonatal Intensive Care Units (시뮬레이션 학습을 위한 호흡곤란증후군 환아 시나리오 개발 및 학습 수행 평가)

  • Lee, Myung-Nam;Kim, Hee-Soon;Jung, Hyun-Chul;Kim, Young-Hee;Kang, Kyung-Ah
    • Child Health Nursing Research
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    • v.19 no.1
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    • pp.1-11
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    • 2013
  • Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.