• 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.

• Korean Journal of Biological Psychiatry
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• v.14 no.2
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• pp.91-98
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• 2007

Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.3
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• pp.444-453
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• 2005

Sometimes the dentists encounter a child who can not be treated with traditional behavior management techniques (for example, reward, restraint, Tell-Show-Do, familialization). In such a case, the dentists use sedation technique. Recently, in Korea, the use of sedation by pediatric dentists is increased. But, the guideline and survey of sedation is very insufficient. Now, we need a survey of sedation practice in Korea. We carried out research on the actual condition about sedation with a questionaire to pediatric dentists in Korea. Followings are the conclusions 1. Sixty six percent of pediatric dentists use sedative agents in their practice. In this study, using sedation shows an increase as compared with the past. 2. Determinative factors of using sedation were orderly behavior management, number of visiting, guidian's opinion, amount of treatment, general condition. 3. Distribution of ages in patients sedated with agents was orderly 3 years, 4-5 years, under 2 years, 6-10 years, more than 10 years. 4. Particular sedative drugs were chloral hydrate 60-70mg/kg, hydroxyzine 10-40mg/kg(25mg/kg), and oral route was the most favorable route. 5. Observation of skin and nail color, pulse oximeter were the most frequently utillized monitoring method during sedation. 6. Only fifty six percent of pediatric dentists complete the cardiopulmonary resuscitation course.

• Journal of the Korean Society of Radiology
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• v.13 no.4
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• pp.653-659
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• 2019

The purpose of this study is to measure the (air dose rate of radiation dose) the discharged patient who was administrated high dose $^{131}I$ treatment, and to predict exposure radiation dose in public person. The dosimetric evaluation was performed according to the distance and angle using three copper rings in 30 patients who were treated with over 200mCi high dose Iodine therapy. The two observer were measured using a GM surverymeter with 8 point azimuth angle and three difference distance 50, 100, 150cm for precise radion dose measurement. We set up three predictive simulations to calculate the exposure dose based on this data. The most highest radiation dose rate was showed measuring angle $0^{\circ}$ at the height of 1m. The each distance average dose rate was used the azimuth angle average value of radiation dose rate. The maximum values of the external radiation dose rate depending on the distance were $214{\pm}16.5$, $59{\pm}9.1$ and $38{\pm}5.8{\mu}Sv/h$ at 50, 100, 150cm, respectively. If high dose Iodine treatment patient moves 5 hours using public transportation, an unspecified person in a side seat at 50cm is exposed 1.14 mSv radiation dose. A person who cares for 4days at a distance of 1 meter from a patient wearing a urine bag receives a maximum radiation dose of 6.5mSv. The maximum dose of radiation that a guardian can receive is 1.08mSv at a distance of 1.5m for 7days. The annual radiation dose limit is exceeded in a short time when applied the our developed radiation dose predictive modeling on the general public person who was around the patients with Iodine therapy. This study can be helpful in suggesting a reasonable guideline of the general public person protection system after discharge of high dose Iodine administered patients.

• Journal of the Korean Institute of Landscape Architecture
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• v.44 no.6
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• pp.84-97
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• 2016

This study was to investigate the user's thermal environments of the children's parks according to pavements and sunscreen types during periods of heat waves. The measurements were conducted at the sand pits, rubber chip pavement, shelters, and green shade ground of the two children's parks located in Jinju, Korea(Chilam: $N\;35^{\circ}11^{\prime}1.4{^{\prime}^{\prim}}$, $E\;128^{\circ}5^{\prime}31.7{^{\prime}^{\prime}}$, elevation 38m, Gaho: $N\;35^{\circ}09^{\prime}56.8{^{\prime}^{\prime}}$, $E\;128^{\circ}6^{\prime}41.1{^{\prime}^{\prime}}$, elevation 24m) over three days during 11-13, August, 2016. The highest ambient air temperatures at the Jinju Meteorological Office during the three measurement days were $35.9{\sim}36.8^{\circ}C$, which corresponded with the extremely hot weather. A series of experiments measured air temperature, relative humidity, wind velocity, black globe temperature, and long-wave and short-wave radiation of the six directions 0.6 m above ground level. The wet bulb globe temperature(WBGT) and the universal thermal climatic index(UTCI) were used to evaluate thermal stress. Surface temperature images of the play equipment were also taken using infrared thermography. Surface temperatures of the play equipment and grounds were used to evaluate burn risk through contact with playground materials. The results showed the following. The maximum air temperatures averaged over 1-hour period for three days were $36.6{\sim}39.4^{\circ}C$. The sun shades reduced those temperatures by up to $2.8^{\circ}C$(green shade) and $1.0^{\circ}C/2.3^{\circ}C$(shelters). The minimum relative humidity values averaged over 1-hour period for three days were 44~50%. The sun shades increased those humidity values by up to 6%(green shade) and 4%/6%(shelters). The risk of heat related illness at the measurement sites of the children's parks were extreme and high in the daytime hours. The maximum WBGT values averaged over a 30-minute period for three days were $31.2{\sim}33.6^{\circ}C$. The sun shades reduced those WBGT values by up to $2.4^{\circ}C$(green shade) and $0.5^{\circ}C/2.1^{\circ}C$(shelters) compared to sandpits, but would not block the risk of heat related illness in the daytime hours. The category of heat stress at the measurement sites of the children's parks were extreme and very strong in the daytime hours. The maximum UTCI values averaged over a 30-minute period for three days were $39.9{\sim}48.1^{\circ}C$. The sun shades reduced those UTCI values by up to $7.8^{\circ}C$(green shade) and $4.1^{\circ}C/8.2^{\circ}C$(shelters) compared to sandpits, but could not lower heat stress category from extreme and very strong to strong and moderate in the daytime hours. According to the burn threshold criteria when skin was in contact with playground materials, the maximum surface temperature of the stainless steels($70.8^{\circ}C$) surpassed three seconds $60^{\circ}C$ threshold for uncoated steel, that of the rubber chip($76.5^{\circ}C$) surpassed five seconds $74^{\circ}C$ threshold for the plastic, that of the plastic slide($68.5^{\circ}C$) and seats($71.0^{\circ}C$) surpassed the one min $60^{\circ}C$ threshold for plastic, respectively. The surface temperatures of shaded play equipment were lower approximately $20^{\circ}C$ than those of play equipment exposed to the sun. Therefore, sun shades can block the risk of burns in daytime hours. Because of the extreme and high risk of heat related illness and extreme and high heat stress at the children's parks during periods of heat waves, parents and administrators must protect children from the use of playgrounds. The risk of burn when contact with play equipments and grounds at the children's parks during periods of heat waves, was very high. The sun shades are essential to block the risk of burn from play equipments and grounds at the children's parks during heat waves.